Production of Epigastric Pain in Duodenal Ulcer by Lower Oesophageal Acid Perfusion

Thirty-six patients with duodenal ulceration were divided into group 1 (30), who had epigastric pain, and group 2 (6), who had pain in the upper abdomen but not in the epigastrium, and were studied by perfusing the lower oesophagus with dilute acid in an attempt to reproduce epigastric pain. In group 1, 25 suffered epigastric pain, indistinguishable from that which they normally had, after perfusion of 30 ml. of 0·1N HC1 in under four minutes (mean values), but none of group 2 had pain.     

Long term management of duodenal ulcer in general practice: How best to use cimetidine?

Two hundred and sixty seven patients with duodenal ulceration were entered into a five year study of two strategies of treatment with cimetidine. Two thirds were treated continuously with 400 mg at bedtime supplemented by temporary increases in dosage if they had symptomatic relapses (group 1), and the remaining third were given intermittent “healing” doses for four to eight weeks if a symptomatic recurrence was judged to have occurred (group 2). Life table analysis showed that the probability of remaining free of clinically important symptoms five years after the start of treatment was 24% (95% confidence interval (CI) 15·5% to 32·6%) in group 1 compared with nil in group 2 (p<0·0001). The median values for the longest periods free from relapse for each patient were 108 weeks in group 1 and 32 weeks in group 2, respectively (p<0·0001; 95% CI of the median difference 36 to 76). Over the five years 10 patients suffered major complications, two requiring emergency surgery, while a further nine had elective surgery because of the failure of medical treatment. There were no deaths that could be attributed either to ulceration or to treatment with cimetidine.Medical management was therefore very satisfactory for most patients, though those treated continuously with cimetidine suffered considerably less from their ulcer symptoms. As 80% of patients studied relapsed during the two years after a healing course of cimetidine, continuous treatment will benefit many patients treated in general practice.     

Plasma TSH and Serum T-4 Levels in Long-term Follow-up of Patients Treated with 131I for Thyrotoxicosis

In February 1972 58% of patients euthyroid after iodine-131 therapy given for thyrotoxicosis between 1954 and 1966 had a high plasma TSH (>7·4 μU/ml) and 42% a normal plasma TSH level. A group of 69 of the euthyroid patients with high plasma TSH levels (25·0±2·0 μU/ml) in 1972 were re-examined 15 and 24 months later. The mean plasma TSH in the 66 patients remaining euthyroid at 15 months was 22·6±1·8 μU/ml, while three patients had become hypothyroid. At 24 months 64 of the patients were still available for study, of whom 61 remained euthyroid with a mean plasma TSH of 21·6±2·0 μU/ml, and a further three had become hypothyroid.All of a group of 61 of the euthyroid patients with normal plasma TSH levels (4·0±0·2 μU/ml) in 1972 remained euthyroid at 24 months with a mean plasma TSH of 4·1±0·3 μU/ml, though the plasma TSH level had become slightly raised in three.The mean serum T-4 level in the euthyroid patients with a high plasma TSH was significantly lower, though still in the normal range, than that in the euthyroid patients with a normal plasma TSH both in 1972 and in 1974.Since no patient with a normal plasma TSH level after iodine-131 treatment six to 18 years earlier for thyrotoxicosis developed hypothyroidism over a two-year period, the follow-up of such patients need not be so rigorous as that of similarly treated euthyroid patients with raised plasma TSH levels in whom hypothyroidism developed at the rate of 5% per year.     

Experience with Coeliac Axis Compression Syndrome

Seven patients with “coeliac axis compression syndrome” are reported. Five were treated surgically, but only two did well. A survey of 200 healthy adults showed epigastric bruits in 6·5%; only one of these had dyspepsia, though dyspepsia was present in 12·5% overall.Caution is urged in attributing a causal relationship between coeliac axis compression and pain and in proceeding to arteriography when compression is suspected on clinical grounds.     

Alcohol consumption in Dundee primigravidas and its effects on outcome of pregnancy

In a population based cohort study information on the consumption of alcohol was obtained from 95% of the 952 consecutive primigravidas who lived in the Dundee district and attended for antenatal care between May 1985 and April 1986. Before realising that they were pregnant more than 90% drank alcohol and 53% were cigarette smokers. During the first four months of pregnancy, however, the proportion of women drinking and smoking fell to 56% and 44%, respectively. Alcohol consumption of more than 120 g absolute alcohol/week (12 or more standard drinks) during pregnancy was related to shorter gestational age (-2·6 weeks), smaller head circumference (-18 mm), shorter (-21 mm) and lighter (-499 g) babies, and lower Apgar scores at five minutes (-0·4, all p<0·01). After adjustment for the effect of smoking, social class, mother''s size, and other confounding factors, however, an alcohol intake of more than 120 g/week was significantly related only to shorter gestational age (-2·0 weeks, p<0·001) and lower Apgar score at five minutes (-0·2, p<0·05). Alcohol intake in the region of 100-119 g/week was significantly related to smaller head circumference (-12 mm, p<0·05). Analysis by type of beverage consumed suggested that beer rather than wine or spirits was associated with a poorer outcome.As there was no detectable effect on pregnancy of alcohol consumption below 100 g/week, it is suggested that health education should be directed towards mothers who drink more than this amount.     

Five- to Eight-year Results of Truncal Vagotomy and Pyloroplasty for Duodenal Ulcer

From January 1963 to December 1965 inclusive 192 men with duodenal ulcer were treated by elective truncal vagotomy and pyloroplasty with one death. Ten subsequent deaths were due to causes unrelated to the ulcer or operation, and 17 patients became untraceable. The remaining 164 patients have been followed up for five to eight years. The late results have been compared with those obtained in a previous study of patients five to eight years after truncal vagotomy and gastroenterostomy, truncal vagotomy and antrectomy, and subtotal gastrectomy respectively for duodenal ulcer.Of the various postgastric operation syndromes early dumping, late dumping, bilious vomiting, and diarrhoea were all less frequent, but not significantly so, after vagotomy and pyloroplasty than after vagotomy and gastroenterostomy.Recurrent ulceration was commoner after vagotomy and pyloroplasty than after all the other operations, the incidence of proved and suspected recurrent ulcers being respectively 6·7 and 7·3% after vagotomy and pyloroplasty, but only 2·5 and 5·9% after vagotomy and gastroenterostomy, 0 and 5·2% after vagotomy and antrectomy, and 0·9 and 3·7% after subtotal gastrectomy. The differences between vagotomy and pyloroplasty and vagotomy and antrectomy or subtotal gastrectomy are statistically significant, but those between vagotomy and pyloroplasty and vagotomy and gastroenterostomy are not.Overall assessment (Visick grading) of the outcome gave poorer results after vagotomy and pyloroplasty than after any other operation, with 14% of category IV cases after vagotomy and pyloroplasty, 11% after vagotomy and gastroenterostomy, 8% after vagotomy and antrectomy, and 6% after subtotal gastrectomy—differences that are significant between vagotomy and pyloroplasty and vagotomy and antrectomy or subtotal gastrectomy but not between vagotomy and pyloroplasty and vagotomy and gastroenterostomy.In the light of these findings it is suggested that truncal vagotomy and pyloroplasty has not lived up to expectations and its place as the currently most popular procedure in the elective surgical treatment of duodenal ulcer should be reconsidered.     

A revision of the new world species of Polytrichophora Cresson and Facitrichophora,new genus (Diptera,?Ephydridae)

The New World species of Polytrichophora Cresson and Facitrichophora new genus, are revised. Fifteen new species are described (type locality in parenthesis): Facitrichophora atrella sp. n. (Costa Rica. Guanacaste: Murciélago [10°56.9''N, 85°42.5''W; sandy mud flats around mangrove inlet]), Facitrichophora carvalhorum sp. n. (Brazil. São Paulo: Praia Puruba [23°21''S, 44°55.6''W; beach]), Facitrichophora manza sp. n. (Trinidad and Tobago. Trinidad. St. Andrew: Lower Manzanilla (12 km S; 10°24.5''N, 61°01.5''W), bridge over Nariva River), Facitrichophora panama sp. n. (Panama. Darien: Garachine [8°04''N, 78°22''W]), Polytrichophora adarca sp. n. (Barbados. Christ Church: Graeme Hall Nature Sanctuary [13°04.2''N, 59°34.7''W; swamp]), Polytrichophora arnaudorum sp. n. (Mexico. Baja California. San Felipe [31°01.5''N, 114°50.4''W]), Polytrichophora barba sp. n. (Cuba. Sancti Spiritus: Topes de Collantes [21°54.4''N, 80°01.4''W, 670 m]), Polytrichophora flavella sp. n. (Peru. Madre de Dios: Rio Manu, Pakitza [11°56.6''S, 71°16.9''W; 250 m]), Polytrichophora marinoniorum sp. n. (Brazil. Paraná: Antonina [25°28.4''S, 48°40.9''W; mangal]), Polytrichophora rostra sp. n. (Peru. Madre de Dios: Rio Manu, Pakitza [11°56.6''S, 71°16.9''W; 250 m]), Polytrichophora sinuosa sp. n. (Trinidad and Tobago. Trinidad. St. Andrew: Lower Manzanilla [12 km S; 10°24''N, 61°02''W]), Polytrichophora mimbres sp. n. (United States. New Mexico. Grant: Mimbres River [New Mexico Highway 61 & Royal John Mine Road; 32°43.8''N, 107°52''W; 1665 m]), Polytrichophora salix sp. n. (United States. Alaska. Matanuska-Susitna: Willow Creek [61°46.1''N, 150°04.2''W; 50 m]), Polytrichophora sturtevantorum sp. n. (United States. Tennessee. Shelby: Meeman Shelby State Park [Mississippi River; 35°20.4''N, 90°2.1''W; 98 m]), Polytrichophora prolata sp. n. (Belize. Stann Creek: Cockscomb Basin Wildlife Sanctuary [16°45''N, 88°30''W]). All known New World species of both genera are described with an emphasis on structures of the male terminalia, which are fully illustrated. Detailed locality data and distribution maps for all species are provided. For perspective and to facilitate recognition, the tribe Discocerinini is diagnosed and a key to included genera is provided.     

A revision of the shore-fly genus Hydrochasma Hendel (Diptera,Ephydridae)

A revision of the shore-fly genus Hydrochasma Hendel. The species of the genus Hydrochasma Hendel are revised, including 27 new species (type locality in parenthesis): H. andeum (Ecuador. Guayas: Boliche (02°07.7''S, 79°35.5''W)), H. annae (United States. Utah. Grand: Swasey Beach (15.3 km N Green River; 39°07''N, 110°06.6''W; Green River; 1255 m)), H. capsum (Ecuador. Orellana: RíoTiputini (0°38.2''S, 76°8.9''W)), H. castilloi (Ecuador. Loja: Catamayo (03°59''S, 79°21''W)), H. crenulum (Peru. Cuzco: Paucartambo, Atalaya (Río Alto Madre de Dios; 12°53.3''S, 71°21.6''W; 600 m)), H. denticum (Ecuador. Orellana: Río Tiputini (0°38.2''S, 76°8.9''W)), H. digitatum (Peru. Madre de Dios: Diamante (Río Alto Madre de Dios; 12°19.9''S, 70°57.5''W; 400 m)), H. distinctum (Costa Rica. Limón: Parque Nacional Barbilla, Sector Casas Negras, (10°0.8''N, 83°28.1''W; 300 m)), H. dolabrutum (Dominican Republic. Barahona: Barahona (18°12''N, 71°5.3''W)), H. edmistoni (Dominican Republic. Azua: near Pueblo Viejo (18°24.8''N, 70°44.7''W)), H. falcatum (Peru. Madre de Dios: Río Manu, Erika (near Salvación; 12°50.7''S, 71°23.3''W; 550 m)), H. glochium (Dominican Republic. Peravia: San José Ocoa (10 km NE; 18°35''N, 70°25.6''W)), H. kaieteur (Guyana. Kaieteur Falls (05°10.5''N, 59°26.9''W)), H. lineatum (Trinidad and Tobago. Trinidad. St. George: Filette (1 km SE; 10°47''N, 61°21''W)), H. miguelito (Honduras. Cortés: San Pedro Sula (8 km S; 15°25.7''N, 88°01.4''W)), H. octogonum (Ecuador. Manabí: Pichincha (01°02.7''S, 79°49.2''W)), H. parallelum (Trinidad and Tobago. Trinidad. St. Andrew: Lower Manzanilla (16 km S; 10°22''N, 61°01''W)), H. peniculum (Dominican Republic. Pedernales: Pedernales (18°01.8''N, 71°44.7''W)), H. rictum (Honduras. Cortés: San Pedro Sula (8 km S; 15°25.7''N, 88°01.4''W)), H. robustum (Brazil. São Paulo. Ubatuba, Praia Puruba (23°21''S, 44°55.6''W; beach)), H. sagittarium (Trinidad and Tobago. Tobago: St. John: Parlatuvier (creek; 11°17.9''N, 60°35''W)), H. simplicum (Costa Rica. Limón: Parque Nacional Barbilla, Sector Casas Negras, (10°01.2''N, 83°26.2''W; 300 m)), H. sinuatum (Belize. Stann Creek: Mullins Creek (17 km N Dangriga; 17°06.2''N, 88°17.8''W)), H. spinosum (Costa Rica. Limón: Westfalia (4 km S; 09°54.5''N, 82°59''W; beach)), H. urnulum (Dominican Republic. Puerto Plata: Río Camu (14 km E Puerto Plata; 19°41.9''N, 70°37.5''W)), H. viridum (Guyana. Karanambo, Rupununi River (ox bow; 03°45.1''N, 59°18.6''W)), H. williamsae (Belize. Stann Creek: Mullins River (17 km N Dangriga; 17°06.2''N, 88°17.8''W)). All known species are described with an emphasis on structures of the male terminalia, which are fully illustrated. Detailed locality data and distribution maps for all species are provided. A lectotype is designated for Discocerina incisum Coquillett and Hydrochasma zernyi Hendel. For perspective and to facilitate genus-group and species-group recognition, the tribe Discocerinini is diagnosed and a key to included genera in the New World is provided.     

Serum tolbutamide and chlorpropamide concentrations in patients with diabetes mellitus

A selective and sensitive gas chromatographic technique was used to measure the steady-state serum concentrations of tolbutamide and chlorpropamide in 97 patients with maturity-onset diabetes mellitus who had been taking these drugs (37 tolbutamide, 60 chlorpropamide) for at least a year. No other antidiabetic agents had been given. The serum tolbutamide concentrations varied widely between the patients (from close to zero to 370 μmol/l (100 μg/ml)), yet the variation in dosage was only sixfold (0·5-3·9 g daily). The serum chlorpropamide concentrations varied even more widely (from close to zero to 882 μmol/l (244 μg/ml)), though the dosage variation was fourfold (125-500 mg daily). There was no systematic relation between dosage and serum concentrations of the drugs.Only 2 (5·4%) of the tolbutamide-treated patients and 10 (16·7%) of the chlorpropamide-treated patients had normal fasting blood glucose concentrations (below 5·5 mmol/l (99 mg/100 ml)), and fewer than half had values below 8·0 mmol/l (144 mg/100 ml). In most cases, therefore, the treatment was insufficient.There was no significant difference in mean fasting blood glucose concentrations between the two treatment groups. The mean steady-state concentration of chlorpropamide, however, was significantly higher than that of tolbutamide. Thus, contrary to common belief, the intrinsic activity of chlorpropamide is apparently not greater than that of tolbutamide. The alleged greater potency of chlorpropamide seems to be related wholly to kinetic differences, such as the less extensive metabolic degradation and slower elimination of the drug.We conclude that treatment with sulphonylureas in conventional dosage is far from optimal and that monitoring the concentrations of these drugs in the blood may help to improve their efficacy.     

Survival of plant tissue at super-low temperatures v. An electron microscope study of ice in cortical cells cooled rapidly

Experiments were carried out with cortical cells in twig bark of mulberry trees in winter in order to clarify the mechanism of survival at super-low temperatures with rapid cooling and rewarming. Attention was given to the relation between the existence of intracellular ice crystals and survival.

Cortical cells were cooled rapidly by direct immersion into liquid nitrogen or isopentane cooled at various temperatures. After immersion, they were freeze-substituted with absolute ethanol at −78°. They were then embedded, sectioned and examined under the electron microscope for the presence and distribution of cavities left after ice removal.

Cells were found to remain alive and contain no ice cavities when immersed rapidly into isopentane baths kept below −60°. Those cells at intermediate temperatures from −20° to −45°, were almost all destroyed. It was also observed that many ice cavities were contained in the cells immersed rapidly into isopentane baths at −30°. The data seem to indicate that no ice crystals were formed when cooled rapidly by direct immersion into isopentane baths below −60° or into liquid nitrogen.

The tissue sections immersed in liquid nitrogen were rapidly transferred to isopentane baths at temperatures ranging from −70° to −10° before rapid rewarming. There was little damage when samples were held at temperatures below −50° for 10 minutes or below −60° for 16 hours. No cavities were found in these cells. Above −45°, and especially at −30°, however, all cells were completely destroyed even when exposed only for 1 minute. Many ice cavities were observed throughout these cells. The results obtained may be explained in terms of the growth rate of intracellular ice crystals.

     

Truncal Vagotomy and Drainage for Chronic Duodenal Ulcer Disease: A Controlled Trial

The results of elective truncal vagotomy and drainage in 547 duodenal ulcer patients are reported. Altogether, 204 patients were randomly allocated to pyloroplasty and 200 to gastrojejunostomy. In 101 patients gastrojejunostomy was electively chosen and in 42 patients the duodenum was opened to confirm the diagnosis. Operative mortality was 0·5%, the incidence of proved recurrent ulceration 3·3%, severe dumping 2%, and severe diarrhoea 1·1%. There were no significant differences between the groups, with the exception of bilious vomiting which occurred more often in patients with gastrojejunostomy.     

Strongyloidiasis in Allied ex-prisoners of war in south-east Asia

One hundred and sixty ex-servicemen who had been prisoners of war in south-east Asia during 1942-5 were investigated for infection with Strongyloides stercoralis. Larvae were found in 44 (27·5%) of the men, who had therefore been infected for 34-37 years. Direct microscopy of the faeces was the most successful diagnostic method, giving a positive result in 37 cases (84%); multiple examinations were often necessary. Faecal culture was positive in 30 cases (68%), but examination of duodenal fluid obtained with the string test gave a positive result in only 17 (39%). The mean blood eosinophil count and mean serum IgE concentration were higher in the infected men, though normal values were often found in individual cases. Clinical manifestations of isolated strongyloides infection were analysed by comparing the infected men with control groups of ex-prisoners in south-east Asia without proved strongyloidiasis and ex-prisoners in Europe. Twenty-nine infected men (66%) complained of non-specific urticaria, and 13 (30%) had pathognomonic larva currens. Gastrointestinal symptoms significantly more common in the infected group were diarrhoea, indigestion, lower abdominal pain, pruritus ani, and weight loss (p <0·05-p <0·0005).The study group was thought to be reasonably representative of Allied ex-servicemen imprisoned in south-east Asia during the second world war. Probably there are many thousands of infected persons in several countries. The worm has an unusual ability to multiply, and larvae may spread throughout the body in immunosuppressed subjects.     

Continuous Intravenous Infusion of Small Doses of Insulin in Treatment of Diabetic Ketoacidosis

Continuous intravenous infusion of small amounts of insulin has been used in the management of a series of patients with diabetic ketoacidosis. In 13 patients with a plasma glucose level on admission of 725 mg/100 ml (± 80 S.E. of mean) and an arterial pH of 7·07 ± 0·05 a mean loading dose of 6·5 ± 0·82 units of soluble insulin was administered intravenously, and thereafter a sustaining infusion of 6·5 ± 0·82 U/hr was continued until ketosis was corrected and the plasma glucose fell below 300 mg/100 ml. The total insulin dose needed to achieve this was 39·2 ± 6·6 units given over a 3 to 10-hour period. Plasma insulin was measured in patients who had not previously received insulin and the mean level at an infusion rate of 4 U/hr was 75·6 ± 8·0 μU/ml. Plasma glucose fell at a regular rate of 101 ± 11 mg/100 ml/hr, and ketosis improved in parallel. Plasma potassium was well maintained throughout treatment. This regimen of treatment was clinically effective and simple to follow.     

Vagotomy and Pyloroplasty for Gastric Ulcer

In a series of 68 patients with gastric ulcer who were treated by vagotomy and pyloroplasty there were no operative deaths, though one patient who received massive transfusions died 14 weeks later from hepatic necrosis probably associated with serum hepatitis. Four patients developed recurrent peptic ulceration requiring further surgical treatment. The clinical condition of all but three of the remainder was satisfactory after an average follow-up period of three years and two months. Of the 14 patients who presented with an acutely bleeding gastric ulcer, one subsequently required gastrectomy for continued bleeding; in all the others the immediate and long-term results were satisfactory. Of 21 patients with a “high” ulcer and 29 with combined gastric and duodenal ulceration one (4·8%) and three (10%) respectively suffered recurrences. We conclude that vagotomy and pyloroplasty is a satisfactory form of treatment for a high or bleeding gastric ulcer, but that for all other gastric ulcers some form of gastric resection is preferable.     

Endocrine Changes in Premature Labour

Plasma oestradiol and progesterone levels in peripheral blood have been studied before and during premature labour of unknown aetiology. Hormones were measured by radio-immunoassay using specific antisera. Levels in patients who delivered prematurely were compared with levels measured serially in 33 primigravidae during normal pregnancy and labour.In 19 out of 25 patients admitted in progressive premature labour the plasma oestradiol level was two standard deviations or more above the mean for the control patients of similar gestational age. The mean (± S.E. of mean) plasma oestradiol in premature labour was 19·1 ± 1·1 ng/ml, similar to levels found in labour at term (18·5 ± 1·4 ng/ml). In contrast, in over 50% of cases levels of plasma progesterone during premature labour lay below the mean for gestation though within the normal range. In six patients studied serially oestradiol levels rose dramatically, high values being detected one to 10 days before the onset of premature labour. Serial progesterone levels gave no consistent trend though one patient showed steadily decreasing values.These studies suggest that the onset of premature labour is preceded by a marked increase in peripheral plasma oestradiol levels, which may be of value not only in the prediction of premature labour but also in its prevention by suppression of the premature oestradiol surge.     

THE INFLUENCE OF THE MOLECULAR WEIGHT OF ANTIGEN ON THE PROPORTION OF ANTIBODY TO ANTIGEN IN PRECIPITATES : II. A STATISTICAL EXAMINATION OF AVAILABLE DATA,INCLUDING SOME PREVIOUSLY UNPUBLISHED

A statistical examination of the available data on the ratio of antibody to antigen in specific precipitates made at or near the optimum shows a definite correlation between the ratio and the molecular weight of antigen (regression coefficient = –0.529 (±0.014)). The authors'' assumption that at this point the antigen molecules are just about covered by a layer of antibody behaving as contiguous spherical ("Svedberg") units of weight 35,200 leads to predicted ratios that in general agree well with those found, though individual experimental determinations may deviate considerably.     

Growth hormone,prolactin, and corticosteroid responses to insulin hypoglycaemia in alcoholics

Plasma growth hormone (GH), prolactin, and corticosteroid responses to insulin-induced hypoglycaemia were studied in 24 men with progressive alcoholism who had been abstinent for two to seven days. Ten normal healthy subjects (five men, five women) served as controls for comparing GH and prolactin responses, while cortisol responses were studied in a further six male controls. Blood samples were taken at intervals after an injection of soluble insulin (0·1 U/kg body weight). All patients developed adequate hypoglycaemia (blood glucose <2·2 mmol/l (<39·6 mg/100 ml)) and nine had impaired GH responses (peak concentration <10 mU/1). Prolactin concentrations fell or remained unchanged in nine patients, eight of whom also had impaired GH responses. In seven patients corticosteroid concentrations decreased from basal concentrations, and six of these patients had impaired GH responses. All three hormone responses were impaired in several patients, and significant correlations were found between the GH and prolactin responses at 45 and 60 minutes. GH response was not correlated with age, duration of drinking, duration of alcoholism, or admitted alcohol intake. GH responses were significantly lower in patients who had the most severe withdrawal symptoms. Our observations of impaired stress responses in some recently abstinent alcoholics may have important implications for the management of alcohol withdrawal syndrome.     

Suggested limits to the use of the hot tub and sauna by pregnant women

Because of reports of the potential risk of maternal hyperthermia to a developing embryo or fetus, studies were done to determine the length of time a woman must stay in a hot tub or sauna before her temperature reaches 38.9°C. The vaginal temperatures of 20 nonpregnant women of childbearing age were recorded while they sat in hot tubs set at 39.0°C or 41.1°C and in a sauna with an average temperature of 81.4°C. Five women were able to remain in the 39.0°C tub and six in the 41.1°C tub until their temperature reached 38.9°C, but in none did their temperature reach that level before 15 minutes in the 39.0°C tub or 10 minutes in the 41.1°C tub. The remainder left in discomfort while their body temperatures were lower. This indicates that the usual use of hot tubs is unlikely to raise a woman''s body temperature to potentially teratogenic levels, although prolonged use may. None of the women were able to remain in the sauna long enough for their temperature to reach 39.9°C.     

Optimization of a Pain Model: Effects of Body Temperature and Anesthesia on Bladder Nociception in Mice

Interstitial cystitis/bladder pain syndrome (IC/BPS) is a debilitating urological condition that is resistant to treatment and poorly understood. To determine novel molecular treatment targets and to elucidate the contribution of the nervous system to IC/BPS, many rodent bladder pain models have been developed. In this study we evaluated the effects of anesthesia induction and temperature variation in a mouse model of bladder pain known as urinary bladder distension (UBD). In this model compressed air is used to distend the bladder to distinct pressures while electrodes record the reflexive visceromotor response (VMR) from the overlying abdominal muscle. Two isoflurane induction models are commonly used before UBD: a short method lasting approximately 30 minutes and a long method lasting approximately 90 minutes. Animals were anesthetized with one of the methods then put through three sets of graded bladder distensions. Distensions performed following the short anesthesia protocol were significantly different from one another despite identical testing parameters; this same effect was not observed when the long anesthesia protocol was used. In order to determine the effect of temperature on VMRs, animals were put through three graded distension sets at 37.5 (normal mouse body temperature), 35.5, and 33.5°C. Distensions performed at 33.5 and 35.5°C were significantly lower than those performed at 37.5°C. Additionally, Western blot analysis revealed significantly smaller increases in spinal levels of phosphorylated extracellular-signal regulated kinase 2 (pERK2) following bladder distension in animals whose body temperature was maintained at 33.5°C as opposed to 37.5°C. These results highlight the significance of the dynamic effects of anesthesia on pain-like changes and the importance of close monitoring of temperature while performing UBD. For successful interpretation of VMRs and translation to human disease, body temperature should be maintained at 37.5°C and isoflurane induction should gradually decrease over the course of 90 minutes.     

A revision of the genus Planinasus Cresson (Diptera,?Periscelididae)

The genus Planinasus Cresson is revised and includes 18 extant and one fossil species. We clarify the status of the three previously described species and describe 15 new species as follows (type locality in parenthesis): Planinasus aenigmaticus (Colombia. Bogota: Bogota (04°35.8''N, 74°08.8''W)), Planinasus neotropicus (Panama. Canal Zone: Barro Colorado Island (09°09.1''N, 79°50.8''W)), Planinasus kotrbae (Ecuador. Orellana: Rio Tiputini Biodiversity Station (0°38.2''S, 76°08.9''W)), Planinasus miradorus (Brazil. Maranhão: Parque Estadual Mirador, Base da Geraldina (06°22.2''S, 44°21.8''W)), Planinasus tobagoensis (Trinidad and Tobago. Tobago. St. John: Parlatuvier (11°17.9''N, 60°39''W)), Planinasus xanthops (Ecuador. Orellana: Rio Tiputini Biodiversity Station (0°38.2''S, 76°8.9''W)), Planinasus argentifacies (Peru. Madre de Dios: Río Manu, Pakitza (11°56.6''S, 71°16.9''W; 250 m)), Planinasus insulanus (Dominican Republic. La Vega: near Jarabacoa, Salto Guasara (19°04.4''N, 70°42.1''W, 680 m)), Planinasus nigritarsus (Guyana. Conservation of Ecological Interactions and Biotic Associations (CEIBA; ca. 40 km S Georgetown; 06°29.9''N, 58°13.1''W)), Planinasus atriclypeus (Brazil. Rio de Janeiro: Rio de Janeiro, Floresta da Tijuca (22°57.6''S, 43°16.4''W)), Planinasus atrifrons (Bolivia. Santa Cruz: Ichilo, Buena Vista (4-6 km SSE; Hotel Flora y Fauna; 17°29.95''S, 63°33.15''W; 4-500 m)), P. flavicoxalis (West Indies. Dominica. St. David: 1.6 km N of junction of roads to Rosalie and Castle Bruce (15°23.8''N, 61°18.6''W)), Planinasus mcalpineorum (Mexico. Chiapas: Cacahoatan (7 km N; 15°04.1''N, 92°07.4''W)), Planinasus nigrifacies (Brazil. São Paulo: Mogi das Cruzes, Serra do Itapeti (23°31.5''S, 46°11.2''W)), Planinasus obscuripennis (Peru. Madre de Dios: Río Manu, Erika (near Salvación; 12°50.7''S, 71°23.3''W; 550 m)). In addition to external characters, we also describe and illustrate structures of the male terminalia and for Planinasus kotrbae sp. n., the internal female reproductive organs. Detailed locality data and distribution maps for all species are provided. For perspective and to facilitate genus-group and species-group recognition, the family Periscelididae and subfamily Stenomicrinae are diagnosed and for the latter, a key to included genera is provided.